Review Jurnal

Nama : NUR AINI

No.Mhs : 201702086
Program : SI KEPERAWATAN(3B)

Jurnal 1
1. Identitas Jurnal :
 Judul : Effectiveness of tutorials for promoting educational integrity: a synthesis paper.
 Pengarang : Brenda M. Stoesz and Anastassiya Yudintseva.
 No Jurnal :
 Nama Jurnal: International Journal for Educational Integrity.
 Jumlah Hal : 22 halaman.
 Tahun Jurnal: 2018.
2. Permasalahan:
-
3. Metode:
Method
Searchstrategy
Our review process was based on the Preferred Reporting Items for Systematic Reviews
and Meta-analyses (PRISMA) statement (Moher et al., 2009; Shamseer et al., 2015). We
conducted electronic searches for studies published in English using the databases
CINAHL, Educational Resources Information Center (ERIC), ProQuest Dissertations
and Theses A&I, PsycINFO, PubMed, Science Direct, Scopus, and Web of Science.
Our search (November 16, 2016) used the following keywords: (a) ‘academic integrity’
OR ‘academic dishonesty’ OR ‘academic misconduct’; AND (b) tutorial OR remedial
instruction OR simulation OR ‘experiential learning’ OR teaching OR methods OR
game OR online; AND (c) AND plagiarism OR ‘self plagiarism’ OR ‘self-plagiarism’ OR
cheating OR ‘duplicate submission’ OR personation OR impersonation OR academi
4. Hasil:
Selection of studies for targeted review
Two reviewers independently screened the titles and abstracts of 1005 articles to determine
inclusion eligibility based on these criteria: (1) the study must have offered a Method
section that clarified the research design; (2) participants must have been postsecondary
students; and (3) the study must have focused on determining the effectiveness of
face-to-face workshops or e-Learning tutorials or combinations of the two forms of content
delivery (i.e., blended approach) to promote academic integrity. A workshop was
defined as “a brief intensive educational program for a small group of people that focuses
on knowledge and skills in a particular area of content” (Miriam-Webster, n.d.). A tutorial
was defined as “self-paced instructional program providing step by step information about
a concept” (Web Finance, n.d.). Blended instruction was defined as a combination of “any
form of instructional technology (e.g., videotape, CD-ROM, web-based training, film) with
face-to-face instructor-led training” (Driscoll, 2002, p. 54).
Articles were excluded if they: (1) were book reviews or critical discussion papers; (2)
focused on the development of the educational intervention without providing details
on effectiveness; or (3) focused on attitudes and/or prevalence of academic misconduct
only. In the event that an abstract was missing, the default procedure was to include ria (n = 44)
 and identified 7 additional articles based on titles for full text review.
We retrieved and examined 51 peer-reviewed publications in detail to determine their
suitability, and excluded 30 that did not meet the inclusion criteria. Reviews on the
effectiveness of educational interventions for promoting academic integrity were not
identified in our search and screening process.

Jurnal 2
5. Identitas Jurnal :
 Judul : Western Balkan Economies in Transition
 Pengarang : Will Bartlet
 No Jurnal : ISSN 2511-2201
 Nama Jurnal: Recent Economic and Social Developments
 Jumlah Hal : 12 halaman
 Tahun Jurnal: 2018
6. Permasalahan:
-
7. Metode:
-
8. Hasil:
In this situation, the University of Applied Sciences Emden-Leer held a conference in April 2016
in order to shed light on selected topics regarding the current
economic situation in this region. From this conference, it was a small step to plan
this book, which presents some of the papers from the conference along with other
specially commissioned chapters to provide a comprehensive view of the main
economic and social issues facing the region. In the meantime, the Western Balkan
summit held in Trieste in July 2017 as part of the “Berlin Process” has proposed a
new action plan for further regional integration on the road to EU membership.1 It
was followed by a fourth summit held in London in July 2018. The pace of activities
Jurnal 3
9. Identitas Jurnal :
 Judul : The Healthcare System and the Pharmaceutical Industry in Indonesia
 Pengarang : Richard Husada and Raymond R. Tjandrawinata
 No Jurnal :
 Nama Jurnal: the New Political Economy of Pharmaceuticals
 Jumlah Hal : 2 halaman
 Tahun Jurnal: 2013
10. Permasalahan:
-
11. Metode:
Indonesia’s health system is characterized by striking regional and social inequalities. Around 55
per cent of the population live in rural areas, spread across some 6000 islands. Healthcare is
mostdeveloped on the main island of Java, which is home to around 51 per cent of the
population. In an effort to address the uneven availability of health services, the government has
established a decentralized network of public health centres (or puskesmas) in the rural areas.
Each provincial and district government operates its own health centres. In 2007 there were
more than 8100 primary health centres, as well as an additional 28,000 mobile and auxiliary
centres. There were
 almost 1300 general hospitals, split evenly between the public and private sectors (DepKes,
2008a). The number has risen significantly in recent years. The government is also actively
promoting the growth of private healthcare, particularly at secondary and tertiary levels, with
the aim of compensating for the shortcomings of the public system (DepKes, 2011). The growing
role
of the private sector in healthcare raises questions about access to health services in general,
although private facilities are required to provide subsidized services to the poor. At the same
time, Indonesia is coming under increasing international pressure to open up its healthcare
services to international competition (International Trade Centre of UNCTAD/WTO, 2005).
12. Hasil:
Pharmaceuticals are expensive relative to average incomes (International Trade Centre of
UNCTAD/WTO, 2005). The market for traditional medicines,however, which are cheaper and
readily available, is thriving. At the same time, demands on the state healthcare system are
rising. Demographic trends show an ageing population and growing migration to the cities.
Indonesia’s elderly population does not constitute the same potential strain on public resources
as the ‘silver tsunami’ phenomenon in other parts of Asia. People aged 65 or over accounted for
just 5.8 per cent of the population in 2008, and will make up only 6.3 per cent in 2013.
Nevertheless, the rise in average life expectancy from 62.8 years in 1990 to nearly 71 years in
2008 has led to an increase in the prevalence of degenerative diseases (WHO, 2011). There are
major deficiencies in human resources in the healthcare sector,
in terms of both numbers and quality of the healthcare workforce. Decentralization is one of
many factors exacerbating long-standing problems with uneven distribution of health workers,
with the workforce biased towards urban areas (Akita and Pirmansah, 2011). These factors have
obvious impacts on the quality, efficiency and equity of healthcare provision. In 2007 the ratio of
general practitioners to population was 19.9 per 100,000 population (although in 2008 the
number improved modestly to 30 per 100,000 population), while the ratio of midwives per
100,000 population was 35.4 (DepKes,2008a). Most general practitioners and midwives work in
urban areas, and only a limited number in remote areas.
Jurnal 4
13. Identitas Jurnal :
 Judul : MENTAL HEALTH SERVICES AND TRADITIONAL HEALINGIN INDONESIA
 Pengarang : Rudy Salan and Thomas Maredzki
 No Jurnal :
 Nama Jurnal: Culture, Medicine and Psychiatry 7
 Jumlah Hal : 2 halaman
 Tahun Jurnal: 1983
14. Permasalahan:
Are the roles compatible? Hence we see this project as a unique effort to apply social science
(ethnomedical) approaches to practical mental health care problem solving.
15. Metode:
-
16. Hasil:
When we use the common term "mental he 'th" services in this paper, we
realize that the environmental stresses and their psychological consequences, which appear in
psychiatric nomenclature as psychosocial and cultural factors, are relative to the specific social
environments and realities of each patient, and each separate culture area. We suggest that
these general mental health problems differ from more serious disorders which may involve
 biologically linked pathogenesis and pathology. In other words, we are aware that the
medicalization of mental health problems tends to distort realities of problems in the interest of
providing therapeutic help within one comprehensive system of care, which in Indonesia is
represented by the Directorate of Mental Health and it's staff. We state this awareness at the
outset in order to anticipate familiar arguments about the relative merits of social models versus
medical models versus public health and other possible models of mental illness and mental
health services (Siegler and Osmond 1974).
Mental health professionals in Indonesia are aware that there must be a connection between
the services offered and the services needed and accepted. The research reported here is an
attempt to provide a more informed understanding of traditional healing as it relates to mental
health care in order to guide practical planning for mental health services in Indonesia. These
data, not previously available, result from a combination of clinical and cultural approaches; the
project is an effort to generate a quite unusual experience for mental health professionals to
become sensitized to the cultural nature of patient problems and patient behavior which
otherwise are too easily converted into disease patterns, leaving little room for the recognition
of the conditions under which they occur and the subjective, cultural interpretations to which
they give rise.

Jurnal 5
17. Identitas Jurnal :
 Judul : The Business Sucks Story
 Pengarang : R. Edward Freema
 No Jurnal :
 Nama Jurnal: Humanist Manag J
 Jumlah Hal : 8 halaman
 Tahun Jurnal: 2018
18. Permasalahan:
-
19. Metode:
The purpose of this essay is to suggest that one of the dominant modes of thought in
our society is a profound mistrust and misunderstanding of the role of business. A dominant
myth in society is that business occupies the moral low ground, separate from ethics or a moral
point of view. This position is characterized as the Bbusiness sucks^ story, and the essay shows
how the enactment of this story underlies business thinking among managers and business
theorists. The essay concludes with a suggestion to rethink and reinvent this story along more
realistic and more empowering lines. Values based capitalism, or stakeholder capitalism, offers
a better way to understand the complex role that business does and should play in modern
society
20. Hasil:

Jurnal 6
21. Identitas Jurnal :
 Judul : A review on Xi Jinping’s ideas of ethnic minority work
 Pengarang : Richard Husada and Raymond R. Tjandrawinata
 No Jurnal : 10.1186/s41257-018-0012-4
 Nama Jurnal: International Journal of Anthropology and Ethnology
 Jumlah Hal : 14 halaman
  Tahun Jurnal: 2018
22. Permasalahan:
-
23. Metode:
Ethnic minority work is being conducted by the Communist Party of China(CPC) in accordance with
Marxist-Leninist nation theory, uniting China’s
many ethnic minorities and launching a hugely important body of work for both
the Party and the nation as a whole. Ever since the 18th National Congress of
the CPC, the Party Central Committee, with General Secretary Xi Jinping at its
centre, has focused heavily on ethnic minority work, convening forums on the
subject in Tibet and Xinjiang in rapid succession, before ultimately convening a
meeting about the general state of the central government’s work in this area in
2014. Xi gave several important speeches on topics including the inspection of
ethnic minority areas, as well as various speeches made during the talks at the
Lianghui1 about related issues. These speeches did not merely constitute an integral part of Xi’s
new ideas,2 concepts and strategies for managing state affairs,
but also established the guiding principle of ethnic minority work for the Party
and the nation in a new historical condition. Xi’s ideas for ethnic minority work
serve as a link between past and future, nurturing past traditions and notions
while introducing new ideas. He is drawing deeply on history to set out a broad
and all-encompassing vision for a diverse future, integrating Chinese characteristics in the
innovation and development of ideas about ethnic minority work.
Learning, understanding and implementing Xi’s ideas for ethnic minority work
require a comprehensive and thorough study of his new political scientific
ideas, concepts and strategies. This is because ethnic minority work is not a separate, isolated field;
it is an essential part of ‘socialism with Chinese characteristics’ as a whole: “Ethnic minority work
involves everything,” it is argued, “and
everything contains elements of ethnic minority work”. This article discusses
and explores Xi’s ideas of ethnic minority work from different viewpoints and
methods.
24. Hasil:
-
Jurnal 7
25. Identitas Jurnal :
 Judul : Rhythmic Diurnal Synthesis and Signaling of Retinoic Acid
in the Rat Pineal Gland and Its Action to Rapidly Downregulate ERK
Phosphorylation
 Pengarang : Anna Ashton1 & Patrick N. Stoney2 & Jemma Ransom1 & Peter McCaffery
 No Jurnal : 55:8219–8235
 Nama Jurnal: Molecular Neurobiology
 Jumlah Hal : 17 halaman
 Tahun Jurnal: 2018
26. Permasalahan:
-
27. Metode:
Methods
Rats
 Male Sprague Dawley (SD) rats at 6–7 weeks of age were used for all experiments unless
otherwise stated, maintained at 20–24 °C with unrestricted access to rodent chow and water.
They were housed under a 12 h light:12 h dark (LD) cycle (lights on 07:00–19:00), or in constant
darkness for the last 2 days (DD). Animals were sacrificed by rising CO2 and cervical dislocation
unless otherwise stated. For polymerase chain reaction (PCR), quantitative PCR (qPCR) and
western blotting, pineal glands were dissected and rapidly frozen on dry ice. For PCR analysis,
adult male SD rats were sacrificed at zeitgeber time (ZT) 2, where ZT0 corresponds to 07:00. For
western blotting analysis, adult male or female SD rats were sacrificed at ZT2 or 7. For
immunohistochemistry, rats were sacrificed by intraperitoneal (IP) injection of pentobarbital at
ZT5 and transcardially perfused with 4% paraformaldehyde in phosphate buffer, the pineal
glands removed and immersed in the same fixative overnight at 4 °C. To determine whether RA
signaling genes exhibit diurnal changes in expression, pineal glands were collected at 6 h
intervals over 24 h (h), ZT0, 6, 12 and 18, and gene expression determined by qPCR. At ZT12 and
18, which occurred during the dark period, dissections were performed under dim red light. To
determine whether changes in RA signaling genes are driven by the light/dark cycle, rats were
housed in constant darkness for 2 days and pineal glands were collected under dim red light at 6
h intervals over 24 h (circadian times (CT) 0, 6, 12 and 18; CT0 and CT12 correspond to
subjective light on and light off, respectively). All animal procedures were carried out in
accordance with Home Office regulations and local ethics committee guidelines.
PCR
Total RNA was extracted from individual pineal glands using an RNeasy mini kit (Qiagen) with
on-column DNase digestion (Qiagen). RNA was quantified using a NanoDrop spectrophotometer
(Thermo Scientific) and precipitated in 100% ethanol, linear acrylamide and ammonium acetate.
cDNAwas synthesized using a High Capacity RNA-to-cDNA kit (Applied Biosystems). PCR analysis
was performed using primers designed for Rdh10, Rdh12, Raldh1, Raldh2, Raldh3, Rara, Rarb,
Rarg, Stra6, Cyp26a1, and Cyp26b1 (Table 1a). PCR products were visualized by agarose gel
electrophoresis and UV transillumination.

28. Hasil:
For RA signaling to occur in a given tissue, the enzymes that synthesize RA from retinol and RARs
must be present. An initial PCR screen was performed on the adult rat pineal gland to determine
the expression of the genes encoding the required components of the RA signaling pathway.
Transcripts encoding the retinol dehydrogenase (RDH) and retinaldehyde dehydrogenase
(RALDH) enzymes that catalyze the first and second steps, respectively, of the conversion of
retinol to RA were detected by PCR (Fig. 1a). Transcript encoding another member of the RDH
family, Rdh12, was also detected, which primarily acts as a retinaldehyde reductase enzyme,
converting retinaldehyde to retinol [47]. Genes encoding each Fig. 1 The components necessary
for retinoic acid signaling are present in the rat pineal gland. mRNA expression of the genes
encoding the synthetic enzymes retinol dehydrogenase, Rdh10, and the three retinaldehyde
dehydrogenases, Raldh1, Raldh2, and Raldh3; the retinal reductase enzyme Rdh12; the retinol
transporter Stra6; the retinoic acid receptors, Rara, Rarb and Rarg; and the catabolic enzymes
cytochrome P450 family 26 (Cyp26) a1 and Cyp26b1; determined by PCR and gel electrophoresis
(a). Protein for RALDH1, RALDH2, RARα and RAR is present, determined by western blotting (b)
Mol Neurobiol (2018) 55:8219–8235 8223 of the three subtypes of RARs, Rara, Rarb and Rarg,
were also found to be expressed. Transcripts encoding Stra6, the retinol transporter, and
Cyp26a1 and Cyp26b1, encoding the RA catabolic enzymes, were also detected. Western
blotting confirmed the presence of RALDH1, RALDH2, RARα and RARβ protein in the adult rat
pineal gland (Fig. 1b). This demonstrates that cells in the pineal gland have the potential to
 synthesize, respond to and degrade retinoic acid. Immunohistochemical Detection of RALDH1
and RARα in the Pineal Gland The components required for RA synthesis and signaling were
found to be present in the pineal gland, therefore their cellular localization was determined for
those of which the antibodies worked by immunohistochemistry; this was the case for
antibodies recognizing the enzyme RALDH1 and the receptor RARα. The pinealocyte is the
principal cell type in the pineal gland, comprising more than 95% of cells [48]. Interstitial cells
resembling astrocytes are also present, several of which express GFAP [49]. To determine which
cell type express RARα and RALDH1, pineal gland sections were double-labeled with antibodies
against SAG, a pinealocyte marker [48], and GFAP. RARα-immunoreactivity was detected in the
cytoplasm of cells throughout the pineal parenchyma, with an average of 14% of cells labeled
(Fig. 2). None of these cells were found to coexpress SAG, however a small subset of 1% of
RARα- positive cells co-expressed GFAP (Fig. 2c). RALDH1- immunoreactivity was also detected
in the cytoplasm of cells, with a uniform distribution throughout the pineal gland sections and
an average of 6% of cells labeled (Fig. 3). There was no double-labeling of RALDH1 with SAG or
GFAP detected. These results suggest that RARα and RALDH1 are predominantly present in the
cytoplasm of SAG-negative pinealocytes, given the number of immunoreactive cells present and
the lack of co-expression with GFAP, with a small proportion of RARα also present in GFAP-
positive cells.

Jurnal 8
29. Identitas Jurnal :
 Judul : 21st Brazilian Diabetes Society Congress
 Pengarang : São Paulo
 No Jurnal : s13098-018-0315-8
 Nama Jurnal: Diabetology & Metabolic Syndrome
 Jumlah Hal : 199 halaman
 Tahun Jurnal: 2018
30. Permasalahan:

31. Metode:
Method
A1 : In a randomized, controlled, prospective, open-label trial, we
randomly assigned 20 insulin independent DM2 patients to undergo
acupuncture (group 1) or in the control group (group 2). Participants
should be between 20 and 75 years old, diagnosed with DM2 for at
least 3 years, and with stable glycemic control (evaluated through
glycated hemoglobin). Patients should not be in use of glucocorticoids or insulin, be pregnant or
have record of nephrotic syndrome,
hepatic insufciency, hyperthyroidism, acromegaly or renal insufciency. Demographic data,
baseline characteristics, biochemical and
metabolic profles were analyzed before the intervention. Participants underwent continuous
glucose monitoring for 14 days, period
in which they did not change diet, exercise or medication. Group 1
received acupuncture 4, 8 and 12 days after installation of the monitoring system. The
acupuncture treatment promotes energetic rebalance and, in this study, diabetes-specifc
treatment points were used
in all patients (B38, IG4, R24, E36 e BP9). This trial was approved by the
 ethics committee (CAAE—60576616.6.0000.5572) and registered at
Brazilian Registry of Clinical Trials (UTN) is U1111-1199-9630
32. Hasil:
Results: There were no statistically signifcant diferences in the baseline characteristics (Table 1). In
group 1, mean glucose level obtained
through 14 days monitoring after acupuncture treatment was
143 ± 28,8 mg/dl, whilst in group 2, who did not undergo acupuncture, the mean level was 165.8 ±
30.2 mg/dl (p-0.015) (Fig. 1).
Jurnal 9
33. Identitas Jurnal :
 Judul : The opinions of senior nursing students
about forensic nursing
 Pengarang : Emine Tuğba Topçu* and Ebru Erek Kaza
 No Jurnal : DOI 10.1186/s41935-018-0045-y
 Nama Jurnal: Egyptian Journal of Forensic Sciences
 Jumlah Hal : 7 halaman
 Tahun Jurnal: 2018
34. Permasalahan:
Nurses are responsible for evaluating patients in a
comprehensive manner, identifying problems intervention to solve problems and recording
when the patients
come to the emergency services due to health problems.

35. Metode:
Methods
Design
The research was carried out as a descriptive study.
Participants
The study sample was 104 students who were in the final year of the 2015–2016 academic year
during the spring semester at the Department of Nursing, the Faculty of Health Sciences of a
state university in Ankara, Turkey. In total, 95 students who were accepted to participate in the
survey were included.
Data collection
Data was collected via two questionnaire form that was developed by researchers parallel to the
literature (Sunmaz et al. 2008; Sharma 2003; Pinar and Bahar 2011; Yelken et al. 2004). Totally it
consisted of 21 questions. One of the data collection tools was a questionnaire (Form 1) (9
questions) developed to determine the sociodemographic characteristics of the nursing senior
students, and a questionnaire (Form 2) (12 questions) to evaluate the opinions of the students
about the forensic nursing. Form 1 is included the six question that were related to age,
gender, mothers’ and fathers’ education level, mothers’ and fathers’ job the students’ socio-
demographic variables consisted of multiple-choice questions about students’ sociodemographic
characteristics, two questions were yes/no questions about the presence of someone interested
in forensics in their family and sought to determine whether
they followed forensic medicine cases in the media, the other one questions about publications
you follow in the media. Form 2 is included six questions were aimed at the tasks of forensic
nurses, the fields in which they worked,forensic nursing subjects, examples of forensic cases and
the education of forensic nursing, which were designed so that students could mark multiple
 choices.
Procedures
During the study’s implementation phase, information was first given to students about the
research’s scope,and their written approvals were obtained. Then, a questionnaire was
distributed to the students who had agreed to participate. After they completed the
questionnaire form, these were collected by the researchers. Filling in
the form took approximately 20 min.
Data analyses
The data were transferred to the computer program by researchers using Statistical Package for
the Social Sciences (SPSS) 16.0. Number percentages and chi-square tests were used to evaluate
the data.
Results
In the study, it was determined that the average age of the students was 22.2 ± 0.79, 84.2%
were female, 55.8% of their mothers had only graduated from primary school, 35.8% of their
fathers had only graduated from high school, 81.1% of their mothers were housewives,
and 30.6% of their fathers were retired. It was determined that nearly all of the students (94.7%)
had no family members interested in forensic medicine,27.4% followed forensic science,
forensic nursing publications/programs in the media, and it was determined that most of them
who did so used the Internet (80.8%) for this. The majority of the students stated that they had
no information about forensic nursing (77.9%) and almost all of them (98.9%) were untrained in
forensic nursing. The students were asked about the definition of forensic nursing in the study;
half of them (50.4%) stated that they did not know what the forensic nursing was, while 17.9%
defined forensic nursing as “nurses working and investigating in forensic cases” (Table 1). The
students who participated in the study were asked about the duties of forensic nurses; 42.1%
stated that they did not know what the duties of the forensic nurses were and the others
stated “recording evidence” among the duties of forensic nurses (40.0%).
Discussion
Upon examining the educational status and jobs of the students’ parents, they were moderate in
terms of the sociocultural level. In our study, very few students stated that they had someone
interested in forensic medicine among their family. However, it was determined that this
did not affect students’ knowledge level with regard to forensic nursing (p > 0.05). Similar to our
study, in the study by Şentürk and Büyükaslan (2013) that sought to determine the knowledge
and opinions of senior nursing students about forensic nursing, only 12% of them had a
family member who was interested in forensic medicine. Most of the students had no one who
was interested in forensics in their family, and it was thought that this situation might affect the
level of knowledge and awareness about forensic cases.

36. Hasil:
In our study, senior nursing students’ knowledge of forensic nursing was insufficient and they
were not trained in this area. The data we have obtained in this study aiming to reveal the
knowledge levels of nursing students about forensic phenomena show a general agreement with
the results of similar studies. In addition, most of the students stated that forensic nursing
education should be suggested as an elective course at the undergraduate level and should be
specialized. Therefore, addition of courses related to forensic nursing to the. undergraduate
curriculum in all universities, opening postgraduate training programs related to the subject, and
increasing scientific activities such as congresses, seminars, and courses are recommended. Both
a tendency towards the advancement of forensic nursing in the nursing profession and basic
principles in undergraduate education should be acquired. Therefore, it is important to evaluate
 the students’ perspectives on forensic nursing.

Jurnal 10
37. Identitas Jurnal :
 Judul : Variation in use of antipsychotic medications in nursing homes in the United States: A
systematic review
 Pengarang : Hannah Cioltan1, Samah Alshehri3, Carol Howe, Jeannie Lee,Mindy Fain, Howard
Eng,Kenneth Schachter1 and Jane Mohler
 No Jurnal : DOI 10.1186/s12877-017-0428-1
 Nama Jurnal: Cioltan et al. BMC Geriatrics
 Jumlah Hal : 12 halaman
 Tahun Jurnal: 2018
38. Permasalahan:

39. Metode:
Methods
Study selection
A literature review was planned and performed using methods specified in the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting
systematic reviews and meta-analyses however a meta-analysis was not performed [18]. Both
controlled vocabulary terms (e.g., MeSH) and key words were utilized to search the following
databases Ovid/ MEDLINE (1946–2015); Elsevier/Embase (1947–2015);
Wiley/Cochrane Library (1898–2015); ThomsonReuters/Web of Science (1898–2015);
EBSCO/PsycINFO(1880’s-2015); EBSCO/CINAHL (1937–2015); and ProQuest/Sociological
Abstracts (1952–2015).
Literature
searches were completed on July 10, 2015. The complete Ovid/MEDLINE search strategy,
analogous to the other database searches, is available in Additional file 1. Reference lists of, and
citations to, the articles eventually through iterative content analysis with expert feedback from
a nursing home expert consensus group of 20 experts comprised of nursing home
administrators, pharmacists, an epidemiologist, a neurologist, two geriatricians, a nursing home
medical director, a nursing home nurse educator, and Healthy Brain Research Network
Collaborating Centers in five states (Table 1). The facility characteristics considered were
extracted from the included studies. A modified Delphi method was used to ensure structure in
categorizing the characteristics into domains as well as determining the possible etiologies of
APM use based on each facility characteristic contributing to use. The rationale for increased
APM use was also extracted from the studies when available.

40. Hasil:
Physical characteristics
The physical characteristics associated with APM use included physical location, facility size,
business type, and the presence of acuity services. Regional variation in
APM use was evident with a positive association between APM use and facility location in the
central south or northeast U.S. regions [23, 25, 26, 29]. However, one
study by Briesacher et al., 2005 expressed a negative association between APM use and nursing
homes in the southern United States [22]. It was also found that facilities in the southern U.S.
tended to prescribe conventional APMs whereas facilities in the northeastern U.S. prescribed
atypical APMs [27]. This positive association between APMs and facilities in the south or
northeast U.S. regions could be due to different state laws and regulation or regionally differing
treatment approaches
of behavioral symptoms of dementia. A positive association between metropolitan location and
APM use was evident and these facilities were more likely to prescribe
atypical APMs [27, 35]. Increased facility size was conversely negatively associated with APM
use, indicating that larger facilities may have more ability to implement
change processes or provide more comprehensive services as a result of economies of scale [25,
26, 29]. Larger facilities were also more likely to prescribe atypical
APMs rather than conventional [27]. Five articles included evidence that for-profit facilities were
positively associated with APM use [24, 26, 31–33]. Kamble et al.
found a positive association between the off-label use of APMs and non-profit facilities [30].
Finally, the presence of acuity services was positively associated with the use of APMs, possibly
due to larger proportion of residents with more complex medical conditions and behavioral
symptoms [26]. Huybrechts et al. found that facilities with Alzheimer special care units more
often prescribed atypical APMs [27]. Staffing characteristics Staffing characteristics play a pivotal
role in the increased use of APMs in nursing homes and include: 1) staffing ratios; 2) the
presence of mental health professionals or physicians; and 3) the presence of social services
(Table 3). Registered nurse (RN) staffing plays a critical role in the increased use of antipsychotics
with a positive association between decreased RN staffing and
APM use [26, 32, 33, 36]. Less time is available per patient when nursing staff to patient ratios
are low, and APMs may serve as a cost-saving alternative to hiring additional RNs. Interestingly,
licensed practical nurse (LPN) to patient ratios have the opposite effect on the use of
antipsychotics. A positive relationship between
LPNs and APMs exists [32]. We theorize that the difference in training between an LPN and RN
could play a role in such association.
In addition to nurse staffing ratios, the presence of mental health professionals, physicians and
social services all affect the use of APMs with the presence of mental health professionals
positively associated with APM use [20, 26, 32]. Facilities with mental health staff
were also more likely to prescribe atypical APMs